Grade 3 AP compression fracture of the pelvis

Case contributed by Dr Ian Bickle

Presentation

Young male in a RTA. Clinically unstable pelvis. Assess for surgery.

Patient Data

Age: 30 years
Gender: Male

Pelvic binder in situ. The left innominate bone is shifted posteriorly disrupting the pubic symphyisis. There is marked widening of the ipsilateral left sacroiliac joint.

There is a fracture of the left L5 tranverse process. Small volume pelvic free fluid.

Pelvic fracture classification

Diagram

Illustrations from https://radiopaedia.org/cases/pelvic-fracture-diagrams.

Courtesy of Matt Skalski.

Case Discussion

This is a high grade compression fracture of the pelvis from a high energy impact from an RTA.

In the absence of any fractures, one can assume ligamentous injuries have occurred.  The vast strength of the pelvic ring has been compromised.

This is an unstable pelvic fracture.

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